Liu Bin, Hu Guoqin, Zheng Wenwen, Liu Shimin, Sun Xiaofei, Zhou Hujun, Zha Zhihong
Department of Otolaryngology,the Second People's Hospital of Hefei,Hefei Hospital Affiliated to Anhui Medical University,Hefei,230011,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Nov;38(11):1050-1055. doi: 10.13201/j.issn.2096-7993.2024.11.010.
To explore the clinical effects of two kinds of nasal bone reductors used for shortened and displaced overlapping external nasal fracture reduction under nasal endoscopy and the impact on ventilation function. From January 2020 to February 2022, 82 patients with shortened and displaced overlapping external nasal fractures diagnosed and treated in the Department of Otolaryngology, the Second People's Hospital of Hefei were collected as the study subjects. The patients were divided into control group(41 cases) and observation group(41 cases) by random number table method. Both groups underwent closed reduction under nasal endoscopy. The control group was treated with traditional straight nasal bone reductor, and the observation group was treated with gun-shaped hook type nasal bone reductor. The success rate of reduction, follow-up rate, clinical effect, and complications were compared between the two groups. The visual analogue scale(VAS) was used to evaluate the aesthetic effect and functional recovery. Rhinomanometry and acoustic rhinometry were used to evaluate nasal ventilation function. The success rate of one-time reduction in the observation group was significantly higher than that in the control group, and the nasal reduction adaptation time was shorter than that in the control group(<0.05). There was no significant difference in the follow-up rate of 95.12% and 92.68% between the two groups. The success rate of one-time reduction in observation group was significantly higher than that in the control group, and the adaptation time for nasal reduction in observation group was shorter than that in the control group(<0.05). There was no significant difference in the follow-up rate of 95.12% and 92.68% between the two groups in six months after surgery. the total clinical effective rate in observation group was higher than that in the control group(94.87% vs 76.32%, <0.05). After surgery, the scores of nasal aesthetics, nasal congestion and olfactory function in both groups were significantly lower compared with the preoperative scores. All the scores in the observed group were lower than that in the control group(<0.05). After surgery, there were significant increases in the minimum cross-sectional area of nasal cavity, volume of nasal cavity and total nasal expiratory volume in both groups. Above indicators in observation group were significantly greater than that in control group. The nasal exhalation and inhalation resistance was significantly lower than that before operation, and the resistance in observation group was significantly lower than that in control group(<0.05). The total incidence of complications was lower than that in observation group(<0.05). The application of gun-shaped hook-type nasal bone reductor in patients with shortened and displaced overlapping external nasal fractures has better success rate of one-time reduction, adaptation time of nasal reduction and treatment outcome. Moreover, it has more advantages in aesthetic effect of nasal appearance, nasal ventilation function and reduction of complications.
探讨两种鼻骨复位器在鼻内镜下用于缩短移位重叠性鼻外骨折复位的临床效果及对通气功能的影响。收集2020年1月至2022年2月在合肥市第二人民医院耳鼻咽喉科诊治的82例缩短移位重叠性鼻外骨折患者作为研究对象。采用随机数字表法将患者分为对照组(41例)和观察组(41例)。两组均在鼻内镜下行闭合复位。对照组采用传统直鼻骨复位器治疗,观察组采用枪形钩型鼻骨复位器治疗。比较两组的复位成功率、随访率、临床效果及并发症。采用视觉模拟评分法(VAS)评估美观效果和功能恢复情况。采用鼻阻力测量法和声反射鼻测量法评估鼻腔通气功能。观察组一次性复位成功率显著高于对照组,鼻复位适应时间短于对照组(P<0.05)。两组随访率分别为95.12%和92.68%,差异无统计学意义。观察组一次性复位成功率显著高于对照组,观察组鼻复位适应时间短于对照组(P<0.05)。术后6个月两组随访率分别为95.12%和92.68%,差异无统计学意义。观察组总临床有效率高于对照组(94.87% vs 76.32%,P<0.05)。术后两组鼻美观度、鼻塞及嗅觉功能评分均较术前显著降低。观察组各项评分均低于对照组(P<0.05)。术后两组鼻腔最小横截面积、鼻腔容积及总鼻呼气量均显著增加。观察组上述指标均显著大于对照组。两组鼻呼气和吸气阻力均显著低于术前,且观察组阻力显著低于对照组(P<0.05)。观察组并发症总发生率低于对照组(P<0.05)。枪形钩型鼻骨复位器应用于缩短移位重叠性鼻外骨折患者,一次性复位成功率、鼻复位适应时间及治疗效果更佳。此外,在鼻外观美观效果、鼻腔通气功能及减少并发症方面更具优势。